Fretecia DAVIS
Brookshire,TX
Summary
Knowledgeable and dedicated customer service professional with extensive experience within the medical and customer service industry. Solid team player with an outgoing, positive demeanor and proven skills in establishing a rapport with clients. Motivate to maintain customer satisfaction and contribute to company success. Articulate, energetic and result-oriented with an exemplary passion for developing relationships, cultivation partnerships, specializing in process optimization, punctual problem solver and avid multitasker.
Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence.
Overview
10
10
years of professional experience
Work History
PATIENT ACCESS REPRESENTATIVE
UT Physicians-Katy
Katy, TX
10.2025 - Current
- Completes thorough and accurate documentation. Adheres to all university policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice
- Serve as administrative liaison with others within and outside assigned areas regarding business and financial issues in purchasing, personnel, facilities and operations
- Assists in verifying insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required timeframes
- Protects the financial integrity of the facility by collecting patient liability, establishing payment arrangements, discussing payment options and screening for eligibility
- Coordinate with insurance providers to expedite prior authorization requests and resolve discrepancies
- Demonstrated excellent problem-solving skills by identifying potential bottlenecks within the registration process and implementing effective solutions to address them.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
- Trained new hires on department procedures, policies, and software systems, ensuring consistent quality service delivery from all team members.
- Manage electronic health record updates accurately, supporting seamless transitions between departments and care continuity.
- Supported medical staff by coordinating diagnostic testing appointments, lab results retrieval, and necessary referrals in a timely manner.
- Developed proficiency in various healthcare software programs for accurate documentation of patient encounters and streamlined workflows within the department.
UNIT SECRETARY/PATIENT ACCESS REPRESENTATIVE
Huffmaster Medical Staffing-Butler Hospital
Providence, RI
05.2025 - 08.2025
- Providing administrative support and coverage for regularly staffed unit secretaries in Partial Hospital and Intensive Outpatient programs.
- Managing unit census/daily attendance and reporting attendance numbers daily.
- Monitor all activities for compliance with ACCME accreditation criteria and Standards for Commercial Support
- Develops, updates, distributes and maintains promotional announcements, written materials, and forms for CME.
- Performing various other clerical duties as needed on unit to support clinical staff, or as assigned by program manager
- Assisted nursing staff with patient care, ensuring timely completion of tasks and improved patient satisfaction.
- Consistently met deadlines for completing administrative tasks while managing competing priorities during high-pressure situations on the unit floor.
- Ensured accuracy of medical documentation by meticulously transcribing physician orders and verifying information with nursing staff as needed.
- Completed administrative patient intakes with case histories, insurance information and mandated forms.
PRE-SERVICE CONTACT REPRESENTATIVE
Texas Children's Hospital
Katy, TX
12.2021 - 08.2024
- Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations
- Knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews
- Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants
- Document clinical review findings, actions, and outcomes in accordance with polices and regulatory and accreditation requirements
- Collaborated cross-functionally with clinical staff and administrators to streamline patient intake procedures and documentation accuracy.
- Coordinated prior authorization requests with insurance providers, resolving discrepancies to expedite approval processes.
- Trained team members on insurance verification protocols and software systems, enhancing service delivery consistency across departments.
- Contributed to patient education by explaining complex insurance terms and procedures in understandable manner.
- Enhanced communication between medical staff and insurance companies, leading to more efficient patient care coordination.
CLAIMS COMPLIANCE AUDITOR/SENIOR ADVOCATE
United HealthCare
Sugarland, TX
05.2016 - 12.2021
- Reviewed and verified assigned codes, sequence diagnosis and procedures according to regulations and accurate clinical information to obtain the specific code to ensure an accurate health information database
- Maintained up to date knowledge of coding and regulatory requirements to accurately assign codes for appropriate reimbursement of health care
- Researched complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
- Created registration within EPIC from documentation provided to accurately record encounter and bill insurance payers
- Developed training materials for staff on compliance protocols, enhancing understanding of regulatory requirements across departments.
- Analyzed audit findings and presented actionable recommendations to senior management for continuous improvement initiatives.
- Analyzed all audit results and resolved all compliance issues.
- Supported the development of company-wide policies and procedures in alignment with industry standards and legal requirements.
- Maintained integrity of general ledger and chart of accounts.
Document Control Specialist
AmerisourceBergen
Sugar Land, TX
06.2017 - 04.2020
- Developed and implemented standardized document control processes, enhancing compliance with regulatory requirements and internal policies.
- Streamlined document review workflows, resulting in improved turnaround times for critical documentation approvals.
- Coordinated cross-functional collaboration to ensure accuracy of data entry and documentation across departments.
- Maintained comprehensive records management systems to support audit readiness and facilitate seamless information retrieval.
- Monitored changes in regulations and updated documentation protocols to align with industry standards consistently.
- Checked accuracy and completeness of documents to identify deficiencies and recommend corrective actions.
Education
BACHELOR OF COMMUNICATIONS -
TEXAS SOUTHERN UNIVERSITY
HOUSTON, TX05-2005
High School Diploma -
Washington High School
Milwaukee, WI06-1999
Skills
- Expert in software programs such as Epic, MS Office, Word, Power Point, Excel, Taleo, Workday, SAP, CRM, Oracle, and Infopro
- Demonstrates ability to partner with all levels internal and external customers, team leader, administer budgets and strategic roll out implementations
- Ability to work in settings of high confidentiality and abide by all rules and regulations for HIPPA
- Trained in conflict management resolutions of customer service issues
- Developed process improvement skill set to enhance quality of work in work environment
- Execute strategic planning, marketing data, and monitoring in the Talent Acquisition process
- Insurance verification
- Medical terminology
- Team leadership
- Training coordination
- Registration and scheduling
- Interpreting physician orders
Timeline
PATIENT ACCESS REPRESENTATIVE
UT Physicians-Katy
10.2025 - Current
UNIT SECRETARY/PATIENT ACCESS REPRESENTATIVE
Huffmaster Medical Staffing-Butler Hospital
05.2025 - 08.2025
PRE-SERVICE CONTACT REPRESENTATIVE
Texas Children's Hospital
12.2021 - 08.2024
Document Control Specialist
AmerisourceBergen
06.2017 - 04.2020
CLAIMS COMPLIANCE AUDITOR/SENIOR ADVOCATE
United HealthCare
05.2016 - 12.2021
BACHELOR OF COMMUNICATIONS -
TEXAS SOUTHERN UNIVERSITY
High School Diploma -
Washington High School